| NPI | 1992779763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09602700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD067966L) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2020-02-04 |